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Issue

October 2013

by Dr. Clara Wong 黃詠儀醫⽣生

Dear fellows members and associated members,

"...For the secret of the care of the patient is in caring for the patient", said Francis W. Peabody in 1925 inan address in Harvard Medical School. These words burned indelibly into the minds of many generations ofmedical students. In your practice, have you ever thought about the actual cares you delivered to yourpatients in the past, are delivering to them at present, and what they will receive in the future?Orthopaedics, is a branch of surgery, to save lives, save limbs and to restore function. With the rapidlychanging world nowadays, does this statement still hold? Does the humanistic concepts embraced byPeabody remain alive?

I attended Annual Meeting of the American Society for Surgery of the Hand (ASSH) in San Francisco a fewdays ago. The theme of the meeting was "Education through Technology". It was my third time attendingthe international annual meeting in the States. This year, I was again fascinated by all the rich andinspiring program. Besides, I was much amazed by the much newer medical and surgical devices,treatment strategies, operating systems, surgical techniques, implants and prosthesis, which were ofhigher technology, complexity and sophistication. There were also many interesting lectures such as, "YourDigital Practice", "Utilizing iPhone and iPad Apps in a Hand Surgery Practice", "Cosmetic Rejuvenation ofthe Hand", "Regenerative Medicine Technologies for Nerve Injuries", and etc. Seemingly, the field ofOrthopaedics is evolving in recent years. Modern orthopaedic and hand surgery developed as aconsequence of the demand created by war injuries. Management of mutilating injuries of the limbs led to

HKOA eNewsletter Oct 2013 http://hkoa.org/newsletter/Oct2013/newsletter_Oct_2013.html

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the current concept of trauma care. The need for secondary reconstruction gave birth to the nowadayssophisticated reconstructive procedures in an attempt to return as near-normal function as possible.Nowadays, how many of you have treated war related injuries? How many of you have to handle majormutilating injuries? There is a worldwide changing in the disease pattern in the field. With an aging andolder working population, disability from osteoarthrosis is getting more common. Sports-related injuries,whether acute or chronic, are of greater prevalence. Repetitive strain injuries, and newer terms such asBlackberry thumb, iPod finger, Gamer's thumb, Stylus finger and Emacs pinky etc, are becoming morepopular and nuisances to many people. Better biologic medications made the number of rheumatoid handand wrist procedures decreasing. Joint replacement, of newer designs and said to be more powerful and ofhigher durability, is now shifted from the group of patients with erosive arthropathy, to a group of patientswith degenerative joint disease. And, the prosthetic replacement is applicable to almost any joint in ourbody. In the States, it is so common in the street to meet a person with more than 3 prosthesis in theirbody.

The disease pattern is changing, and the surroundings around us are also changing dramatically. Manyscientific discoveries, medical advances, increasingly complex technologies, and information technologies,are emerging. In ASSH Meeting, I heard of many terms which I had never imagined they were currentlybelonged to the medical field and were so intimate to our daily practice...."Personal genomics", a branch ofgenomics concerned with the sequencing and analysis of the genome of an individual, to determine thelikelihood of trait expression and disease risk. "Crowd-sourcing", a practice of obtaining ideas orinformation, by soliciting inputs from an online community, rather than from a traditional body, to helptreating patients. "Molecular imaging", a non-invasive manner to better understand the fundamentalmolecular pathways inside our body, in the help to treat diseases. "Mobile health", a practice of medicinesupported by mobile devices, to collect community and clinical health data, deliver healthcare informationto practitioners, researchers, and patients, real-time monitoring of patient vital signs, and direct provisionof care via mobile telemedicine. "Synthetic biology", is the design and construction of biological devicesand systems to treat diseases. "Systems medicine", looks at the dynamic systems of the human body aspart of an integrated whole, incorporates biochemical, physiological and environment interactions thatsustain life. And also, digitalization of health records, robotics, artificial intelligence, nanotechnology, 3Dprinting technology and regenerative medicine, all are transforming the healthcare and in the hope to upliftthe people. While the human living condition can be improved, the actual needs and demands of thepatients are also changed. It is inevitably that patients' demand and the advancing technology arecompeting with each other.

Nevertheless, there is not without problem with the present advances. With the paperless medical system,digitalization of health records and mobile health, doctor-patient interactions are altered. Patient can checktheir body condition, get their blood or other investigation results and e-medical advices through differentapps and internet platform. Sometimes, the doctor-patient relationship is also drifted into a kind of doctor-client relationship. With the information and communication technology, decision of the choice ofmanagement, whether operated or not, what kind of operations, what types of external or internalprosthetic devices, is lead by the patients. Focus of some care-givers is also shifted. Medical care may haveevolved from a profession to a business, with tremendous waste and unsustainable costs in futileresearches, products packaging, promotion, unnecessary treatment, overdo preventive medicine and etc.Materialization on the part of care-giver appears to be a larger part in the patient care equation. Reliabilityof the "evidence based medicine" and confidence in the quality of a scientific method is also anotherproblem. Ethical issues, such as that related to stem cell technology and genetic discrimination, adiscrimination on the basis of information obtained from one's genome, by health insures or employers,and towards pre-symptomatic genetic testing of minors, are serious problems as well.

I hope, with advancing world and healthcare transformation, better care and outcomes at lower cost can bedelivered to the patients, without any major trade-off. And, Peabody's concept is still vividly aliveeveryday.

HKOA eNewsletter Oct 2013 http://hkoa.org/newsletter/Oct2013/newsletter_Oct_2013.html

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Golf Day Result (18 Sep 2013)Overall Champion: Dr Danny TsoiBest Gross Score: Dr Ho Ho PakMen Division Champion: Dr Chak Hing Chung1st runner-up: Dr Dicky Lam 2nd runner-up: Dr Albert WongWomen DivisionChampion: Ms Alice Cheng (spouseof Dr. Wong Man Shun ) 1st runner-up: Mrs Fhronux Tsoi (spouse of Dr Danny Tsoi )

Our HKOA dragon boat team haswon the HKMA Invitational MiniDragon Boat Race cum DavidFang Cup Silver PlateChampionship on 18 August2013!

Video linkPhoto album

New Issue of JOTR is availableonline!Please click to the following link toview the latest issue of Journal ofOrthopaedics, Trauma andRehabilitation: June 2013 (Volume17, Issue 1): http://ejotr.org/current_issue.aspx

New website of PublicInformation Service (PIC)The PIC of Hong Kong College ofOrthopaedic Surgeons has beenrelocated to the following address:http://www.orthoinfo-hkcos.org

The 33rd Hong KongOrthopaedic AssociationAnnual Congress"Defying the Aging Spine - OurMisson Contiunes"Date: 23-24 Nov 2013Venue: The Hong Kong Convention& Exhibition Centre

Poster presentation schedulePoster presentationinstructionsOral presentation instructionsAward papers presentationsOral free papers presentation(in alphabetical order ofauthors)

AOTrauma Seminar-PaediatricOrthopaedic Challenge andRecent Advances26-27 Oct 2013 Link

Asian Federation of Foot &Ankle Surgeons 5th ScientificMeeting&Hong Kong Foot &Ankle Society 1st ScientificMeeting30 November, 2013 (Sat) Link

1st Foot & Ankle CadavericDissection & ReconstructionWorkshop1 December, 2013 (Sun) Link

ASEAN Arthroscopy and SportsMedicine Congress 2013, KualaLumpur, Malaysia6-9 November 2013 Link

中華醫學會第⼗十五屆骨科學術會議暨第八

屆COA國際學術⼤大會會議時間：2013年年11⽉月7-10⽇日會議地點：北京國家會議中⼼心

征⽂文截⽌止時間：2013年年7⽉月31⽇日提前注冊截⽌止⽇日期：2013年年9⽉月30⽇日網 址:http://www.coachina.org/2013

HKOA eNewsletter Oct 2013 http://hkoa.org/newsletter/Oct2013/newsletter_Oct_2013.html

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More meetings information can be found in Orthopaedic Calender fromHKCOS: http://www.hkcos.org.hk/calendar/index.aspx

For Enquiry: Dr. FY Ng, Honorary Secretary, HKOAc/o Department of Orthopaedics and Traumatology, Queen MaryHospital, Pokfulam, Hong Kong

Telephone: (852) 2255 5305Fax: (852) 2817 4392Email: secretary@hkoa.orgWebsite - www.hkoa.org

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